Acute heart failure is the leading cause of hospital admission in people over 65, and accounts for more than 67,000 people being admitted to hospital in England each year. All people admitted to hospital with suspected acute heart failure should receive treatment from a dedicated specialist heart failure team.
The latest NICE guidance for acute heart failure underlines the importance and benefits of specialist treatment for patients with the condition.
Recent research has shown that, while mortality rates for acute heart failure are improving, management and care of the condition still varies widely. An audit from the National Institute for Cardiovascular Outcomes Research found that half of patients admitted with heart failure in England and Wales ended up in non-specialist wards, and had a 54% greater chance of dying as a result.
The audit also found that good clinical management by heart failure and cardiology specialists results in significantly better outcomes for patients.
The new guidance recommends that all hospitals admitting people with suspected heart failure should provide a specialist heart failure team that is based on a cardiology ward and provides outreach services. In addition, they should ensure that all people being admitted to hospital with suspected heart failure have early and continuing input from a dedicated specialist heart failure team.
The guidance also provides recommendations on the use of early blood tests and echocardiography to diagnose acute heart failure. It also covers the continuation of treatment with beta-blockers after a person has had an episode of acute heart failure.
Dr Suzanna Hardman, consultant cardiologist and member of the guideline development group, said: “Untreated acute heart failure kills and can have a serious long- term impact on quality of life, but this can be transformed with specialist care. This guideline should ensure all patients admitted to hospital with acute heart failure are cared for by a specialist consultant-led multidisciplinary heart failure team.
“For most, this care will be delivered by a heart failure unit within a cardiology ward but for the few whose needs prioritise care elsewhere, the specialist team will be involved on an outreach basis. The use of tests for possible new heart failure will prevent delayed diagnoses.
“The requirement for a specialist team review within two weeks of going home will minimise readmissions and integrate acute and community care as outlined in NICE’s chronic heart failure guideline. This should result in a reduction in the number of people who die as a result of acute heart failure, improved well-being and less pressure on hospital beds.”
Image Credit: Patrick J. Lynch, medical illustrator; C. Carl Jaffe, MD, cardiologist
